Effect of 8-month vertical whole body vibration on bone, muscle performance, and body balance: a randomized controlled study

Effects on Mass Transfer in the Bone Lacunar-Canalicular System under Different Radial Extracorporeal Shock Waves

BACKGROUND

The bone lacunar-canalicular system (LCS) is an important microscopic infrastructure for signaling and solute transport in bone tissue, which guarantees the normal physiological processes of bone tissue, and there is a direct relationship between osteoporosis and intrabody mass transfer; however, the mass transfer pattern of the LCS has not yet been clarified under different intensities of in extracorporeal shock waves. The present study aims to assess the effect of extracorporeal shock waves on mass transfer in LCS.

METHODS

Sodium fluorescein tracer was taken as the transport substance, and the fluorescence intensities of osteocytes at lacuna in bovine cortical bone were used to indicate the mass transfer effect. The free diffusion and different extracorporeal shock waves were performed in LCS experiments and the fluorescence intensities of the superficial, shallow, middle, and deep layers of osteocytes, which were arranged in a proximity-to-distant order away from the Haversian canal, were detected by laser scanning confocal microscopy.

RESULTS

The results showed that, under different shock waves, the fluorescence intensities of superficial lacunae were the highest in an osteon, followed by shallow and middle layers, and the fluorescence intensities of deep lacunae furthest from the Haversian canal were the lowest, with a decreasing trend and a decreased range of 44.75-97.11%. Relative to free diffusion, the fluorescence intensities of the lacunae in each layer increased by 33.16%, 20.56%, 16.11%, and 26.64% in the superficial, shallow, middle, and deep layers of osteocytes, respectively, under the effect of the extracorporeal shock waves at 1 bar; the fluorescence intensities of the middle layer increased by 100.03% when the intensity was 5 bar, and average fluorescence intensities increased the most with an incremental value of 81.34% in all different shock waves; the fluorescence intensities of the lacunae of each layer was enhanced with a range of 110.93-161.03% by 8 bar.

CONCLUSION

Extracorporeal shock waves promoted tracer mass transfer within the LCS, and the higher the shock wave magnitudes, the larger the mass transfer in LCS. The transport of solute molecules, nutrients, and signaling molecules within the LCS was facilitated by the extracorporeal shock waves, which may help to address bone diseases such as osteoporosis from the direction of mass transfer in LCS.

Low intensity, high frequency vibration training to improve musculoskeletal function in a mouse model of volumetric muscle loss

This study's objective was to investigate the extent to which two different levels of low-intensity vibration training (0.6 g or 1.0 g) affected musculoskeletal structure and function after a volumetric muscle loss (VML) injury in male C57BL/6J mice. All mice received a unilateral VML injury to the posterior plantar flexors. Mice were randomized into a control group (no vibration; VML-noTX), or one of two experimental groups. The two experimental groups received vibration training for 15-min/day, 5-days/week for 8 weeks at either 0.6 g (VML-0.6 g) or 1.0 g (VML-1.0 g) beginning 3-days after induction of VML. Muscles were analyzed for contractile and metabolic adaptations. Tibial bone mechanical properties and geometric structure were assessed by a three-point bending test and microcomputed tomography (µCT). Body mass-normalized peak isometric-torque was 18% less in VML-0.6 g mice compared with VML-noTx mice (p = 0.030). There were no statistically significant differences of vibration intervention on contractile power or muscle oxygen consumption (p ≥ 0.191). Bone ultimate load, but not stiffness, was ~16% greater in tibias of VML-1.0 g mice compared with those from VML-noTx mice (p = 0.048). Cortical bone volume was ~12% greater in tibias of both vibration groups compared with VML-noTx mice (p = 0.003). Importantly, cross-section moment of inertia, the primary determinant of bone ultimate load, was 44% larger in tibias of VML-0.6 g mice compared with VML-noTx mice (p = 0.006). These changes indicate that following VML, bones are more responsive to the selected vibration training parameters than muscle. Vibration training represents a possible adjuvant intervention to address bone deficits following VML.

Effects of whole-body vibration training as an adjunct to conventional rehabilitation exercise on pain, physical function and disability in knee osteoarthritis: A systematic review and meta-analysis

BACKGROUND

Knee osteoarthritis (KOA) is a prevalent degenerative joint condition that impairs mobility and quality of life. While whole-body vibration training (WBVT) shows promise as an adjunct to conventional KOA rehabilitation, its efficacy remains unclear due to inconsistent clinical evidence.

OBJECTIVE

To elucidate the combined effects of WBVT and rehabilitation exercise on pain, physical function, and disability in KOA management through a systematic review and meta-analysis.

METHODS

A comprehensive search was conducted across eight electronic databases (PubMed, Web of Science, Embase, PEDro, SPORTDiscus, Scopus, ScienceDirect, and China National Knowledge Infrastructure) up to February 2024. Inclusion criteria were (i) randomized controlled trials comparing combined WBVT and rehabilitation exercise versus rehabilitation alone in KOA (ii) reported clinical outcomes (iii) human studies, and (iv) publications in English or Chinese. Trial quality was assessed using the PEDro scale and Cochrane risk-of-bias tool. The meta-analysis employed random-effects models in Review Manager 5.3 to account for heterogeneity, supported by sensitivity analyses for robustness and subgroup analyses on WBVT frequency effects.

RESULTS

Sixteen RCTs comprising 589 participants were included. The systematic review found that WBVT combined with conventional rehabilitation significantly reduced pain and improved physical function in KOA patients. The meta-analysis quantified these effects, showing that WBVT significantly (i) reduced knee pain (MD = -0.43, 95% CI [-0.70, -0.16], p = 0.002), with greater reductions observed from high-frequency WBVT, and (ii) increased isokinetic knee peak torque compared to rehabilitation exercise alone. No significant differences were found in balance, functional mobility, and disability outcomes. Sensitivity analysis of high-quality trials supported these results. However, the heterogeneity among studies and variations in control group interventions warrant cautious interpretation.

CONCLUSION

WBVT seems to be effective in reducing pain and enhancing muscle strength in KOA patients when used in conjunction with conventional rehabilitation. Future high-quality RCTs must standardize WBVT protocols, emphasize long-term follow-up, and refine dosage for clinically meaningful outcomes. Systematic review registration: International prospective register of systematic reviews (PROSPERO CRD42024508386).

Effects of whole-body vibration in horizontal position on bone, quality of life, and balance in postmenopausal osteoporosis

Objectives

The present study aimed to analyze the effect of high-frequency, low-magnitude whole-body vibration (WBV) therapy in horizontal position on bone, quality of life, pain, and balance in postmenopausal women.

Patients and methods

Sixty postmenopausal women were included in this prospective, randomized controlled study between May 2015 to September 2015. The patients were randomized into three groups, with 20 participants in each group: (i) WBV + infrared group, (ii) infrared group, and (iii) control group. Bone mineral density of the lumbar and femoral regions of all the patients was measured using dual-energy X-ray absorptiometry. In addition, osteocalcin and hydroxyproline values were measured. Quality of life was assessed using the Short Form-36, pain was assessed using the Visual Analog Scale, and balance was assessed based on the participants' performance in the Berg balance test.

Results

Seven patients (two from the vibration + infrared group and five from the infrared group) could not continue the study, and the analyses were conducted with the remaining 53 patients (mean age: 56.9±5.1 years; range, 45 to 65 years). At the end of a three-month treatment period, no statistically significant difference was found in bone mineral density, bone turnover markers, pain, and quality of life of the patients in all three groups compared to the pretreatment values. Berg balance test results showed a statistically significant increase after treatment in all three groups.

Conclusion

High-frequency, low-magnitude WBV performed under supervision in postmenopausal women was not found to be effective in improving bone, quality of life, pain, and balance. Future studies for determining effective vibration protocols having a longer duration and higher frequency of sessions are warranted.

The Efficacy of Whole-Body Vibration in Managing Postburn Victims' Complications: A Systematic Review

Burn injury is a complicated traumatic event with both systemic and local consequences. These complications include long periods of bed rest, pain, muscle weakness, vitamin D deficiency, and bone mineral density loss. Whole-body vibration demonstrated effectiveness in improving muscle power and bone mineral density in various musculoskeletal populations. This systematic review of randomized controlled trials aims to assess evidence for the effectiveness of using whole-body vibration on postburn survivors with at least 1% total body surface area on sensory and motor outcomes. A systematic search was conducted across six databases, which are, PubMed, Cochrane, PEDro, Scopus, Web of Science, and Google Scholar, from inception till March 2022. Retrieved studies were screened by title and abstract and full-text in two stages using Rayyan web-based. Included studies were assessed for risk of bias using the Cochrane risk of bias tool ROB 2.0. Six randomized controlled trials with 203 participants were included. Five of the included studies demonstrated an overall high risk of bias. Compared to conventional physiotherapy programs, whole-body vibration demonstrated improvement in functional mobility and balance using timed up and go and Biodex balance assessment, respectively. However, there were no differences between whole-body vibration and conventional physiotherapy program alone in bone mineral density and muscle power. Although the current evidence of whole-body vibration is limited, whole-body vibration combined with traditional physical therapy programs may improve functional mobility and balance in postburn survivors compared to physical therapy programs alone.

Effect of Mechanical Stimuli and Zoledronic Acid on the Femoral Bone Morphology in Rats with Obesity and Limited Mobility

Our study aimed to compare the impact of zoledronic acid and whole-body vibration (WBV) as a non-pharmacological method of treatment for early obesity/immobility-related osteoporosis in male rat models. In total, 36 male Wistar rats were assigned to the following groups: obese control with immobility (Control, n = 12) and two experimental groups (n = 12 each), including obese and immobile rats subjected to whole-body vibration with an acceleration level of 3 m/s² g (obesity and immobility + WBV) and obese and immobile rats that received an intramuscular injection of zoledronic acid at a dose of 0.025 mg/kg (obesity and immobility + ZOL). After the 8th and 16th week of treatment, n = 6 rats from each group were euthanized and isolated femora were subjected to a histological examination of bone, and analysis of the expression of osteoprotegerin (OPG) and the receptor activator of nuclear factor kappa-B ligand (RANKL) involved in bone turnover and the amount of thin collagen fibers (PSR stain). The obtained results showed that short-term vibrotherapy (up to 8 weeks) can lead to improvement in bone remodeling in rat models with obesity and limited mobility.

Effect of whole-body vibration on neuromuscular activation and explosive power of lower limb: A systematic review and meta-analysis

OBJECTIVE

The review aimed to investigate the effects of whole-body vibration (WBV) on neuromuscular activation and explosive power.

METHODS

Keywords related to whole-body vibration, neuromuscular activation and explosive power were used to search four databases (PubMed, Web of Science, Google Scholar and EBSCO-MEDLINE) for relevant studies published between January 2000 and August 2021. The methodology of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses was used. The eligibility criteria for the meta-analysis were based on PICOST principles. Methodological assessment used the Cochrane scale. Heterogeneity and publication bias were assessed by I2 index and funnel plots, respectively. The WBV training cycle is a random effect model. Publication bias was also assessed based on funnel plots. This study was registered in PROSPERO (CRD42021279439).

RESULTS

A total of 156 participants data in 18 studies met the criteria and were included in the meta-analysis for quantitative synthesis. Results of the meta-analysis showed significant improvements in lower limb neuromuscular activation immediately after WBV compared with the baseline (SMD = 0.51; 95% CI: 0.26, 0.76; p<0.001), and no significant heterogeneity was observed (I2 = 38%, p = 0.07). In addition, the highest increase in lower limb explosive power was observed (SMD = 0.32; 95% CI: 0.11, 0.52; p = 0.002), and no significant heterogeneity (I2 = 0%, p = 0.80) was noted.

CONCLUSIONS

WBV training could improve neuromuscular activation and explosive power of the lower limb. However, due to different vibration conditions, further research should be conducted to determine standardized protocols targeting performance improvement in athletes and healthy personnel experienced in training.

Effects of whole-body vibration at different periods on lumbar vertebrae in female rats

The current study aimed to investigate the effects of whole-body vibration (WBV) before and after ovariectomy on lumbar vertebrae, and to observe whether the positive effects of WBV before and after ovariectomy on lumbar vertebrae in rats could be maintained after vibration stopped. Three-month-old female rats were divided into four groups (n = 45/group): control (CON), ovariectomy (OVA), WBV before ovariectomy (WBV-BO), and WBV after ovariectomy (WBV-AO) groups. For 1-8 weeks, WBV-BO group was subjected to vertical WBV. At the 9th week, the rats in WBV-BO, WBV-AO, and OVA groups were ovariectomized. During 11-18 weeks, WBV-AO group was subjected to vibration. For 19-26 weeks, no intervention was done for rats. The lumbar vertebrae were examined by Micro-CT, compressive test, creep test, and microindentation test. At the 8th week, the displacement of the L1-L2 annulus fibrosus in WBV-BO group was 18% smaller compared with CON group (p<0.05). At the 18th week, the elastic modulus of the L5 vertebral body in WBV-BO and WBV-AO groups was 53% and 57% higher than that in CON group, respectively (p<0.05); the displacement of the L1-L2 annulus fibrosus in WBV-BO group was 25% smaller than those in the other groups (p<0.05). At the 26th week, there was no significant difference in the displacement of the L1-L2 annulus fibrosus between WBV-BO group and other groups (p>0.05); the elastic modulus of the L5 vertebral body had no significant difference between WBV-AO group and CON group (p>0.05). Our results demonstrated that WBV before ovariectomy effectively prevented disc degeneration with significant effects up to 8 weeks after ovariectomy. The vertebral mechanical properties could be significantly improved by WBV after ovariectomy, but the residual effect did not maintain after WBV stopped.

Characterisation of the transient mechanical response and the electromyographical activation of lower leg muscles in whole body vibration training

The aim of this study is to characterise the transient mechanical response and the neuromuscular activation of lower limb muscles in subjects undergoing Whole Body Vibration (WBV) at different frequencies while holding two static postures, with focus on muscles involved in shaping postural responses. Twenty-five participants underwent WBV at 15, 20, 25 and 30 Hz while in hack squat or on fore feet. Surface electromyography and soft tissue accelerations were collected from Gastrocnemius Lateralis (GL), Soleus (SOL) and Tibialis Anterior (TA) muscles. Estimated displacement at muscle bellies revealed a pattern never highlighted before that differed across frequencies and postures (p < 0.001). After stimulation starts, muscle oscillation peaks, drops and further stabilises, suggesting the occurrence of a neuromuscular activation to reduce the vibration-induced oscillation. The oscillation attenuation at the SOL muscle correlated with its increased activation (rho = 0.29, p < 0.001). Furthermore, only specific WBV settings led to a significant increase in muscle contraction: WBV-induced activation of SOL and GL was maximal in fore-feet (p < 0.05) and in response to higher frequencies (30 Hz vs 15 Hz, p < 0.001). The analysis of the mechanical dynamics of lower leg muscles highlights a resonant response to WBVs, that for the SOL correlates to the increased muscle activation. Despite differing across frequencies and postures, this resonant behaviour seems to discourage the use of dynamic exercises on vibrating platforms. As for the most efficient WBV combination, calf muscle response to WBVs is maximised if those muscles are already pre-contracted and the stimulation frequencies are in the 25–30 Hz range.

The combined effects of noise and vibration stress on sex hormone levels, fertility capacity, and the protective role of cinnamon extract in rats: an experimental study

Due to the high prevalence of noise and vibration exposure in most industries, this study aimed to investigate the effects of simultaneous exposure to noise and vibration on sex hormone levels and fertility capacity in rats, as well as the protective effects of the hydroalcoholic extract of cinnamon. In this experimental study, 64 adult male rats were randomly divided into 8 groups, control, noise (N), cinnamon (C), noise + cinnamon (NC), vibration (V), vibration + cinnamon (VC), noise + vibration (NV) and groups Noise + Vibration + Cinnamon (NVC). Groups C, NC, VC and NVC received a 75 mg/kg dose of cinnamon extract by gavage. The rats of groups N and NC, V and VC and NV and NVC were each exposed to noise at 100 dB (700-5700 Hz), vibration acceleration of 1 m/s² rms (frequency range of 4-8 Hz), and simultaneously exposed to vibration and noise for 8 hours continuously every night (23:00-7:00) for 50 consecutive nights. Next, a blood sample was taken from the lateral tail vein and the levels of LH, FSH and testosterone were measured with ELISA kits. Each male rat was caged with 3 female rats for one week. The pregnant rats were kept until all of the rat pups were born. Then the fertility capacity, the total number of births, the live births and the birth weight of the rat pups were analyzed with the software SPSS. In the N and NV groups, compared to the control group, a significant decrease in LH and testosterone levels, the number of births and the birth weight was observed (p < 0.05). A significant decrease in testosterone levels, number of births and birth weight was observed in Group V compared to the control group (p < 0.05). In addition, significant increases in LH, FSH and testosterone levels and in birth weight were observed in group C compared to the control group (p < 0.05). Significant increases in FSH and testosterone levels, birth weight, and the number of births were noted in the NVC group compared to the NV group (p < 0.05). Based on the results of this study, cinnamon extract could alleviate the destructive effects of noise and vibration (both individually and in combination) on levels of sex hormones (LH, FSH, and testosterone), the number of births, and birth weight.

An overview of the effects of whole-body vibration on individuals with cerebral palsy

The purpose of this review is to examine how whole-body vibration can be used as a tool in therapy to help improve common physical weaknesses in balance, bone density, gait, spasticity, and strength experienced by individuals with cerebral palsy. Cerebral palsy is the most common movement disorder in children, and whole-body vibration is quickly becoming a potential therapeutic tool with some advantages compared to traditional therapies for individuals with movement disorders. The advantages of whole-body vibration include less strain and risk of injury, more passive training activity, and reduced time to complete an effective therapeutic session, all of which are appealing for populations with physiological impairments that cause physical weakness, including individuals with cerebral palsy. This review involves a brief overview of cerebral palsy, whole-body vibration's influence on physical performance measures, its influence on physical performance in individuals with cerebral palsy, and then discusses the future directions of whole-body vibration therapy in the cerebral palsy population.

Impact of Local Vibration Training on Neuromuscular Activity, Muscle Cell, and Muscle Strength: A Review

This paper presents a review of studies on the effects of local vibration training (LVT) on muscle strength along with the associated changes in neuromuscular and cell dynamic responses. Application of local/direct vibration can significantly change the structural properties of muscle cell and can improve muscle strength. The improvement is largely dependent on vibration parameters such as amplitude and frequency. The results of 20 clinical studies reveal that electromyography (EMG) and maximal voluntary contraction (MVC) vary depending on vibration frequency, and studies using frequencies of 28-30 Hz reported greater increases in muscle activity in terms of EMG (rms) value and MVC data than the studies using higher frequencies. A greater muscle activity can be related to the recruitment of large motor units due to the application of local vibration. A greater increase in EMG (rms) values for biceps and triceps during extension than flexion under LVT suggests that types of muscles and their functions play an important role. Although a number of clinical trials and animal studies have demonstrated positive effects of vibration on muscle, an optimum training protocol has not been established. An attempt is made in this study to investigate the optimal LVT conditions on different muscles through review and analysis of published results in the literature pertaining to the changes in the neuromuscular activity. Directions for future research are discussed with regard to identifying optimal conditions for LVT and better understanding of the mechanisms associated with effects of vibration on muscles.

Multi-mechanical waves against Alzheimer's disease pathology: a systematic review

Alzheimer’s disease (AD) is the most common cause of dementia, affecting approximately 40 million people worldwide. The ineffectiveness of the available pharmacological treatments against AD has fostered researchers to focus on alternative strategies to overcome this challenge. Mechanical vibrations delivered in different stimulation modes have been associated with marked improvements in cognitive and physical performance in both demented and non-demented elderly. Some of the mechanical-based stimulation modalities in efforts are earlier whole-body vibration, transcranial ultrasound stimulation with microbubble injection, and more recently, auditory stimulation. However, there is a huge variety of treatment specifications, and in many cases, conflicting results are reported. In this review, a search on Scopus, PubMed, and Web of Science databases was performed, resulting in 37 papers . These studies suggest that mechanical vibrations delivered through different stimulation modes are effective in attenuating many parameters of AD pathology including functional connectivity and neuronal circuit integrity deficits in the brains of AD patients, as well as in subjects with cognitive decline and non-demented older adults. Despite the evolving preclinical and clinical evidence on these therapeutic modalities, their translation into clinical practice is not consolidated yet. Thus, this comprehensive and critical systematic review aims to address the most important gaps in the reviewed protocols and propose optimal regimens for future clinical application.

Jumping rope and whole-body vibration program effects on bone values in Olympic artistic swimmers

INTRODUCTION

Artistic swimming seems not to benefit bone development like other out-of-water physical activities. To increase bone acquisition, artistic swimming should combine water training with weight-bearing impact or strength activities. Artistic swimmers can be a population at risk of developing osteopenia and osteoporosis in later life. The aim of the present study was to evaluate the effects of a training program on bone mineral density (BMD), bone mineral content (BMC) and body composition in an Olympic artistic swimming team.

METHODS

Sixteen women aged 17-21 years, who train 30 h/week, at the Olympic Training Centre (Barcelona, Spain), were followed up over two seasons. The 1st season involved regular artistic swimming training without specific training to reduce the risk of osteopenia. The exercise intervention, jumping rope and whole-body vibration, was added in the 2nd season. The protocol included 20 min of training 2 days per week, over a 22-week period. Dual energy x-ray absorptiometry measured the bone variables and body composition. The daily diet, medical history and bone turnover markers were evaluated.

RESULTS

The intervention program increased BMD on lumbar spine (2.10%, p = 0.002), total hip (2.07%, p = 0.001), and femoral neck (2.39%, p = 0.02). Lower limb's fat mass decreased (10.17%, p = 0.038). No significant differences were found for any of the measured anthropometric characteristics between both time points in the 1st season. In conclusions, combined jump rope and vibration should be considered to reduce the risk of bone damage in artistic swimmers.

Efficacy of whole-body vibration on balance control, postural stability, and mobility after thermal burn injuries: A prospective randomized controlled trial

OBJECTIVE

To investigate the additive effects of whole-body vibration (WBV) training to the traditional physical therapy program (TPTP) on balance control, postural stability, and mobility after thermal burn injuries.

DESIGN

A single-blinded, randomized controlled study.

SETTING

Outpatient physical therapy setting.

PARTICIPANTS

Forty participants, 20-45 years old, with deep second-degree thermal burn involving the lower limbs and trunk, with 35%-40% total body service area, were randomly allocated either into the study group or the control group.

INTERVENTION

The study group received WBV plus TPTP while the control group received the TPTP only. Interventions were applied three sessions a week for eight weeks.

OUTCOME MEASURES

Anteroposterior stability index (APSI), mediolateral stability index (MLSI), overall stability index (OSI), timed-up and go (TUG), and Berg balance scale (BBS) were measured at baseline and after eight weeks of interventions.

RESULTS

There were statistically significant differences in APSI, MLSI, OSI, BBS, and TUG in favor of the WBV group after eight weeks of intervention (P < 0.001). After eight weeks of intervention, the mean (SD) for APSI, MLSI, OSI, BBS, and TUG scores were 1.87 ± 0.51, 41.36 ± 0.18, 1.95 ± 0.56, 47.2 ± 6.12, and 8.15 ± 1.05 seconds in the WBV group, and 2.41 ± 0.71, 2.21 ± 0.54, 2.68 ± 0.73, 40.65 ± 4.7, and 10.95 ± 2.44 seconds in the control group, respectively.

CONCLUSIONS

The whole-body vibration training combined with the TPTP was more beneficial in improving APS, MLS, OSI, TUG, and BBS than TPTP alone. It might be considered a useful adjunctive therapy in treating patients with healed wounds with a deep second-degree burn of the trunk and lower limbs.

The effects of biophysical stimulation on osteogenic differentiation and the mechanisms from ncRNAs

Ample proof showed that non-coding RNAs (ncRNAs) play a crucial role in proliferation and differentiation of osteoblasts and bone marrow stromal cells (BMSCs). Varied forms of biophysical stimuli like mechanical strain, fluid shear stress (FSS), microgravity and vibration are verified to regulate ncRNAs expression in osteogenic differentiation and influence the expression of target genes associated with osteogenic differentiation and ultimately regulate bone formation. The consequences of biophysical stimulation on osteogenic differentiation validate the prospect of exercise for the prevention and treatment of osteoporosis. In this review, we tend to summarize the studies on regulation of osteogenic differentiation by ncRNAs beneath biophysical stimulation and facilitate to reveal the regulatory mechanism of biophysical stimulation on ncRNAs, and provide an update for the prevention of bone metabolism diseases by exercise.

Does Low-Magnitude High-Frequency Vibration (LMHFV) Worth for Clinical Trial on Dental Implant? A Systematic Review and Meta-Analysis on Animal Studies

Being as a non-pharmacological medical intervention, low-magnitude high-frequency vibration (LMHFV) has shown a positive effect on bone induction and remodeling for various muscle diseases in animal studies, among which dental implants osteointegration were reported to be improved as well. However, whether LMHFV can be clinically used in dental implant is still unknown. In this study, efficacy, parameters and side effects of LMHFV were analyzed via data before 15th July 2020, collecting from MEDLINE/PubMed, Embase, Ovid and Cochrane Library databases. In the screened 1,742 abstracts and 45 articles, 15 animal studies involving 972 implants were included. SYRCLE's tool was performed to assess the possible risk of bias for each study. The GRADE approach was applied to evaluate the quality of evidence. Random effects meta-analysis detected statistically significant in total BIC (P < 0.0001) and BV/TV (P = 0.001) upon loading LMHFV on implants. To conclude, LMHFV played an active role on BIC and BV/TV data according to the GRADE analysis results (medium and low quality of evidence). This might illustrate LMHFV to be a worthy way in improving osseointegration clinically, especially for osteoporosis.

Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO, identifier: NCT02612389

Effect of Whole-Body Vibration Training on Physical Fitness and Postural Control in Working-Age Patients on Haemodialysis

OBJECTIVE

To evaluate the effect of whole-body vibration training on working-age people on haemodialysis.

DESIGN

Consecutive case series study.

SUBJECTS

Seventeen working-age participants on maintenance haemodialysis were enrolled.

METHODS

A 12-week whole-body vibration training programme, including different postures, was designed. The study evaluated and compared physical fitness, including a list of tests such as the 5-repetition sit-to-stand test, hand grip test, 2-min step test, and 8-foot up-and-go test; modified Berg balance scale; static and dynamic balance function; and quality of life, using a quality of life questionnaire before and after the training.

RESULTS

All physical fitness parameters, except grip strength on the left side, improved after whole-body vibration training. For balance, the modified Berg balance scale demonstrated enhanced scores for equilibrium, with eyes closed on a stable surface and eyes open on an unstable surface, and movement velocity under the fast condition along the left and right directions (p=0.011). No significant improvements in quality of life were found.

CONCLUSION

Whole-body vibration exercise training enhanced physical fitness and static and dynamic balance control in working-age participants on haemodialysis.

Efficacy of low-magnitude high-frequency vibration (LMHFV) on musculoskeletal health of participants on wheelchair: a study protocol for a single-blinded randomised controlled study

BACKGROUND

Osteoporosis is an age-related disease with progressive loss of bone, leading to fragile bone. It is one of the major health issues in older adults and causes medical, social and economic impacts globally. Patients with osteoporosis have high risk of osteoporotic fractures. Low-magnitude high-frequency vibration (LMHFV) is a non-invasive biophysical intervention providing whole-body mechanical stimulation. Previous studies showed that LMHFV is beneficial to muscle strength, postural control, balancing ability, new bone formation, spinal bone mineral density (BMD) and blood circulation. During the LMHFV treatment, older adults need to stand upright on the platform for 20 min/day. However, some physically weak elderlies with poor musculoskeletal ability cannot stand for a long period. Therefore, the design of vibration platform is modified for the disabled patients to treat at sitting position and the efficacy of LMHFV on this group of elderlies will be verified. It is hypothesised that new design of LMHFV is beneficial to wheelchair users in terms of vertebral BMD, muscle health and musculoskeletal functions.

METHODS

This study is a single-blinded randomised controlled trial to investigate the effect of LMHFV on vertebral BMD, muscle health, balancing ability and functional ability in wheelchair users (mainly on wheelchair for outdoor activities). Healthy elderlies aged 65 years or above with walking difficulties and using wheelchair are eligible. Exclusion criteria are those: (1) who cannot stand and walk independently, (2) who have vibration treatment before, (3) with malignancy, (4) with acute fractures or severe osteoarthritis, (5) with cardiovascular concern such as with pacemaker in situ, (6) with chronic inflammatory conditions known to affect muscle metabolism such as rheumatoid arthritis and (7) with high frequency of physical activities, such as participants who participated in regular exercise five times a week or more. Recruited participants will be randomised to either LMHFV or control group. Participant assigned to LMHFV group will receive LMHFV (35 Hz, 0.3g (g=gravitational acceleration), 20 min/day, at least three times/week) for 6 months. The primary outcome is BMD at the lumbar spine to be assessed by dual-energy X-ray absorptiometry that is clinically recommended for the diagnosis of osteoporosis. All primary and secondary outcome assessments for all groups will be performed in the investigators' institute at baseline and 6 months post treatment.

DISCUSSION

This study aims to investigate the effects of LMHFV on wheelchair users. The findings of this study will help to confirm the efficacy of LMHFV on vertebral BMD, muscle health, balancing ability and functional outcomes in wheelchair using elderlies. LMHFV therapy is an intervention strategy that is easy to implement at the community healthcare level or individually at home that has previously been proven to reduce fall risk and muscle strength at the lower limb. The ultimate goal is to improve their bone and muscle quality of wheelchair users, as well as enhancing their quality of life.

TRIAL REGISTRATION NUMBER

ClinicalTrials.gov (NCT04180267).

A comparison of the effects of different stretching methods on flexibility, muscle activity, and pain threshold in ballet dancers; a preliminary randomized controlled trial

BACKGROUND

The purpose of this study is to compare the effects of stretching methods on flexibility, muscle activation, and pressure pain threshold in ballet dancers, and to suggest an effective stretching method.

METHODS

Thirty-three ballet dancers were randomized to the static stretching group (n = 11), muscle energy technique stretching group (n = 11), and vibration-assisted stretching group (n = 11). The angle of hip joint extension in arabesque, activation of the rectus femoris in devéloppé, and pressure pain threshold on the rectus femoris in the sitting position were measured to compare the effects of the different stretching methods. Paired t-test was used to compare the pre and post-intervention findings within each group and one-way analysis of variance to compare the difference in the amount of changes among the groups.

RESULTS

The hip joint extension angles increased in all stretching methods (p < 0.05); however, vibration-assisted stretching and muscle energy technique stretching were more effective than static stretching (p < 0.05). The activation of the rectus femoris decreased in all groups (p < 0.05); however the muscle energy technique stretching group and vibration-assisted stretching group showed a significant decrease in muscle activation compared with the static stretching group (p < 0.05). The pressure pain threshold significantly improved only in the static stretching group (p < 0.05); and vibration-assisted stretching group (p < 0.05).

CONCLUSIONS

Compared with static stretching and muscle energy technique stretching, vibration-assisted stretching is a beneficial method for improving flexibility, muscle activation, and pressure pain threshold in ballet dancers.

[Neuromuscular stimulation in conditions of vibrational physical activity for the prevention of osteoporosis]

The review discusses the modern possibilities of non-drug rehabilitation of patients with osteoporosis. Osteopenia (osteoporosis) and osteoporosis-associated bone fractures are a global public health problem, and an intensive search is undergoing for new methods of treatment, prevention, diagnosis and screening of this disease. Innovative technologies for influencing bone remodeling using vibration training seem to be an effective method that allows you to simultaneously positively affect maintaining bone density, increasing muscle strength and improving coordination, especially in elderly patients. The evolution of study of the effects of intense neuromuscular stimulation under accelerated physical exertion, which began with fundamental work on experimental animals, now includes numerous clinical studies. Vibrational physical activity is one of the methods of biomechanical stimulation, which is considered as an innovative method in the field of rehabilitation and physiotherapy. The physiological basis of this effect is intensive neuromuscular stimulation, which causes a reflex reaction of skeletal muscles. This scientific review describes the results of both monotherapy and combined methods of exposure to vibrational stimulation using modern pharmacotherapy. Attention is focused on the positions of importance in the design of the study and the planning of rehabilitation programs of uniformly accelerated training.

C. R. Twelve Weeks of Whole Body Vibration Training Improve Regucalcin, Body Composition and Physical Fitness in Postmenopausal Women: A Pilot Study

(1) Background: Regucalcin or senescence marker protein 30 (SMP30) is a Ca2+ binding protein discovered in 1978 with multiple functions reported in the literature. However, the impact of exercise training on SMP30 in humans has not been analyzed. Aging is associated with many detrimental physiological changes that affect body composition, functional capacity, and balance. The present study aims to investigate the effects of whole body vibration (WBV) in postmenopausal women. (2) Methods: A total of 13 women (aged 54.3 ± 3.4 years) participated in the study. SMP30, body composition (fat mass, lean mass, and bone mass) and physical fitness (balance, time up and go (TUG) and 6-min walk test (6MWT)) were measured before and after the 12 weeks of WBV training. (3) Results: The WBV training program elicited a significant increase in SPM30 measured in plasma (27.7%, p = 0.004) and also in 6MWT (12.5%, p < 0.001). The WBV training also significantly reduced SPM30 measured in platelets (38.7%, p = 0.014), TUG (23.1%, p < 0.001) and total body fat mass (4.4%, p = 0.02). (4) Conclusions: There were no significant differences in balance, lean mass or bone mass. The present study suggests that 12 weeks of WBV has the potential to improve SPM30, fat mass, TUG and 6MWT in postmenopausal women.

WHOLE-BODY VIBRATION TRAINING PROTOCOLS IN OBESE INDIVIDUALS: A SYSTEMATIC REVIEW

ABSTRACT Obesity is a chronic degenerative disease. Whole-body vibration (WBV) devices make it possible to control the intensity of exercises through their variables: frequency, amplitude and vibration time, thus enabling interventions in these populations. The objective of this study was to review the applications, protocols and results of WBV devices in obese individuals. A systematic literature review was conducted using the descriptors and terms verified in DeCS (LILACS and SCIELO) and MeSH (PubMED). Of the thirteen studies selected, seven used an experimental and six a quasi-experimental methodological design. Eleven studies analyzed chronic responses and two studies acute responses to WBV training. Frequency values ranged between 30 and 35 Hz, amplitude was around 2 mm, and in terms of intensity, most of the training protocols used a gradual increase in WBV throughout the intervention. Eight studies added dynamic exercises and extra loads to the WBV. The mean total WBV exposure time varied around 20’ distributed in 1 or 2 series, with vibration times of 30” to 60” and the same rest time. The mean frequency of interventions was around 2 to 3 times a week, with a mean intervention time of 10 months. The main results include: decrease in body weight and improvement in the physiological variables of oxygen absorption, bone mineral density and arterial profile, indicating that WBV can be a safe tool in the fight against obesity and its implications. Level of Evidence II. Systematic Review of Level II Studies.

Skeletal response to whole body vibration and dietary calcium and phosphorus in growing pigs

The quality and strength of the skeleton is regulated by mechanical loading and adequate mineral intake of calcium (Ca) and phosphorus (P). Whole body vibration (WBV) has been shown to elicit adaptive responses in the skeleton, such as increased bone mass and strength. This experiment was designed to determine the effects of WBV and dietary Ca and P on bone microarchitecture and turnover. A total of 26 growing pigs were utilized in a 60-d experiment. Pigs were randomly assigned within group to a 2 × 2 factorial design with dietary Ca and P concentration (low and adequate) as well as WBV. The adequate diet was formulated to meet all nutritional needs according to the NRC recommendations for growing pigs. Low Ca, P diets had 0.16% lower Ca and 0.13% lower P than the adequate diet. Pigs receiving WBV were vibrated 30 min/d, 3 d/wk at a magnitude of 1 to 2 mm and a frequency of 50 Hz. On days 0, 30, and 60, digital radiographs were taken to determine bone mineral content by radiographic bone aluminum equivalency (RBAE) and serum was collected to measure biochemical markers of bone formation (osteocalcin, OC) and bone resorption (carboxy-terminal collagen crosslinks, CTX-I). At day 60, pigs were euthanized and the left third metacarpal bone was excised for detailed analysis by microcomputed tomography (microCT) to measure trabecular microarchitecture and cortical bone geometry. Maximum RBAE values for the medial or lateral cortices were not affected (P > 0.05) by WBV. Pigs fed adequate Ca and P tended (P = 0.10) to have increased RBAE max values for the medial and lateral cortices. WBV pigs had significantly decreased serum CTX-1 concentrations (P = 0.044), whereas animals fed a low Ca and P diet had increased (P < 0.05) OC concentrations. In bone, WBV pigs showed a significantly lower trabecular number (P = 0.002) and increased trabecular separation (P = 0.003), whereas cortical bone parameters were not significantly altered by WBV or diet (P > 0.05). In summary, this study confirmed the normal physiological responses of the skeleton to a low Ca, P diet. Interestingly, although the WBV protocol utilized in this study did not elicit any significant osteogenic response, decreases in CTX-1 in response to WBV may have been an early local adaptive bone response. We interpret these data to suggest that the frequency and amplitude of WBV was likely sufficient to elicit a bone remodeling response, but the duration of the study may not have captured the full extent of an entire bone remodeling cycle.

Acute Effects of Whole-Body Vibration on the Postural Organization of Gait Initiation in Young Adults and Elderly: A Randomized Sham Intervention Study

Whole-body vibration (WBV) is a training method that exposes the entire body to mechanical oscillations while standing erect or seated on a vibrating platform. This method is nowadays commonly used by clinicians to improve specific motor outcomes in various sub-populations such as elderly and young healthy adults, either sedentary or well-trained. The present study investigated the effects of acute WBV application on the balance control mechanisms during gait initiation (GI) in young healthy adults and elderly. It was hypothesized that the balance control mechanisms at play during gait initiation may compensate each other in case one or several components are perturbed following acute WBV application, so that postural stability and/or motor performance can be maintained or even improved. It is further hypothesized that this capacity of adaptation is altered with aging. Main results showed that the effects of acute WBV application on the GI postural organization depended on the age of participants. Specifically, a positive effect was observed on dynamic stability in the young adults, while no effect was observed in the elderly. An increased stance leg stiffness was also observed in the young adults only. The positive effect of WBV on dynamic stability was ascribed to an increase in the mediolateral amplitude of "anticipatory postural adjustments" following WBV application, which did overcompensate the potentially destabilizing effect of the increased stance leg stiffness. In elderly, no such anticipatory (nor corrective) postural adaptation was required since acute WBV application did not elicit any change in the stance leg stiffness. These results suggest that WBV application may be effective in improving dynamic stability but at the condition that participants are able to develop adaptive changes in balance control mechanisms, as did the young adults. Globally, these findings are thus in agreement with the hypothesis that balance control mechanisms are interdependent within the postural system, i.e., they may compensate each other in case one component (here the leg stiffness) is perturbed.

Transmission of Acceleration From a Synchronous Vibration Exercise Platform to the Head During Dynamic Squats

Many research studies have evaluated the effects of whole-body vibration exercise on muscular strength, standing balance, and bone density, but relatively few reports have evaluated safety issues for vibration exercises. Knee flexion reduces acceleration transmission to the head during static exercise. However, few studies have evaluated dynamic exercises. The purpose of this investigation was to evaluate the transmission of acceleration to the head during dynamic squats. Twelve participants performed dynamic squats (0°-40° of knee flexion) on a synchronous vertical whole-body vibration platform. Platform frequencies from 20 to 50 Hz were tested at a peak-to-peak nominal displacement setting of 1 mm. Transmissibilities from the platform to head varied depending on platform frequency and knee flexion angle. We observed amplification during 20 and 25 Hz platform vibration when knee flexion was <20°. Vibration from exercise platforms can be amplified as it is transmitted through the body to the head during dynamic squats. Similarly, this vibration energy contributes to observed injuries such as retinal detachment. It is recommended that knee flexion angles of at least 20° and vibration frequencies above 30 Hz are used when performing dynamic squat exercises with whole-body vibration.

Is Vibration Training Good for Your Bones? An Overview of Systematic Reviews

Whole-body vibration (WBV) intervention studies and reviews have been increasing lately. However, the results regarding its effects on bone tissue in different populations are still inconclusive. The goal of this overview was to summarize systematic reviews assessing the effects of WBV training on bone parameters. Three electronic databases were scanned for systematic reviews and meta-analyses evaluating the effects of WBV on bone tissue. The search had no time restrictions and was limited to articles written in English. Vibration protocols and the main bone parameters included in each review were extracted. Methodological quality was assessed and analyses were conducted stratifying by age. 17 reviews and meta-analyses fulfilled the inclusion criteria. No increase or small improvements in bone mineral density (BMD) after WBV interventions were observed in reviews regarding postmenopausal women. One intervention study regarding young adults was included and reported no bone-related benefits from WBV. Most reviews including children and adolescents with compromised bone mass showed an improvement of BMD at lower limbs, lumbar spine, and whole body. In conclusion, WBV interventions seem to help children and adolescents with compromised bone mass to increase their BMD, but these improvements are limited in postmenopausal women and there is insufficient evidence for young adults. Further research is also needed to identify the ideal parameters of WBV training focused on bone health.

Whole Body Vibration Exposure on Markers of Bone Turnover, Body Composition, and Physical Functioning in Breast Cancer Patients Receiving Aromatase Inhibitor Therapy: A Randomized Controlled Trial

Introduction: Women with breast cancer are often prescribed aromatase inhibitors, which can cause rapid loss of bone mass leading to significant potential for morbidity. Vibration training has been shown to be helpful in reducing bone turnover in postmenopausal women without cancer. Aim: To examine the effect of vibration stimulus on markers of bone turnover in breast cancer patients receiving aromatase inhibitors. Methods: Thirty-one breast cancer survivors undergoing treatment with aromatase inhibitors were randomized to vibration stimulus (n = 14) or usual care control (n = 17). Low-frequency and low-magnitude vibration stimulus (27-32 Hz, 0.3g) was delivered in supervised sessions via standing on a vibration platform for 20 minutes, 3 times per week for 12 weeks. The primary outcome was blood markers of bone resorption (serum N-telopeptide X/creatine) and formation (serum type 1 procollagen N-terminal propeptide; P1NP). Other study outcomes body composition as well as measures of physical functioning. Outcomes were compared between groups using analysis of covariance adjusted for baseline values as well as time on aromatase inhibitors. Outcomes: On average, participants were 61.5 years old and overweight (ie, body mass index = 28.5 kg/m²). Following vibration training, there was no significant difference between groups for bone resorption (adjusted group difference 0.5, P = .929) or formation (adjusted group difference 5.3, P = .286). There were also no changes in any measure of physical functioning body composition. Conclusions: Short-term low-magnitude vibration stimulus does not appear to be useful for reducing markers of bone turnover secondary to aromatase inhibitors in breast cancer patients; nor is it useful in improving physical function or symptoms. However, further investigations with larger samples and higher doses of vibration are warranted. Trial Registration: Australian and New Zealand Clinical Trials Registry (ACTRN12611001094965).

Effects of Whole Body Vibration on Tibia Strength and Structure of Competitive Adolescent Swimmers: A Randomized Controlled Trial

BACKGROUND

Swimming has no effect on bone mass or structure. Therefore, adolescent swimmers present similar bone strength values when compared to normo-active controls, and lower values when compared to weight-bearing athletes. It thus seems necessary to try to improve bone structure and strength of adolescent swimmers through a weight-bearing intervention in order to reduce the risk of suffering osteoporosis later in life.

OBJECTIVE

To evaluate the effects of a 6-month whole body vibration (WBV) intervention on bone strength and structure of adolescent swimmers.

DESIGN

Randomized controlled trial.

SETTING

Research center.

PARTICIPANTS

A total of 51 swimmers (14.4 ± 2.0 years) participated in the study.

METHODS

Swimmers were randomly allocated into 2 groups: 20 swimmers (9 females) who only performed their swimming training, and 31 swimmers (15 females) who performed their swimming training and received a WBV intervention (3.6-11.6 g) 3 times per week during 6 months (VIB).

OUTCOME MEASUREMENTS

Peripheral quantitative computed tomography was performed in the nondominant tibia of all swimmers at 4%, 38%, and 66% of the tibia length before and after the intervention.

RESULTS

No differences between groups in any bone structure variable were found at pre- or postintervention. Both groups presented similar improvements in time, and no group by time interactions were found, suggesting that the WBV intervention was not intense enough to achieve positive changes in bone strength or structure.

CONCLUSION

WBV, at the chosen intensities and durations, had no effect on adolescent swimmers' bone strength or structure. Future studies should test other weight-bearing interventions aiming to improve bone strength and structure of adolescent swimmers.

LEVEL OF EVIDENCE

II.

Whole-Body-Vibration Training and Balance in Recreational Athletes With Chronic Ankle Instability

CONTEXT

  Deficits in the propioceptive system of the ankle contribute to chronic ankle instability (CAI). Recently, whole-body-vibration (WBV) training has been introduced as a preventive and rehabilitative tool.

OBJECTIVE

  To evaluate how a 6-week WBV training program on an unstable surface affected balance and body composition in recreational athletes with CAI.

DESIGN

  Randomized controlled clinical trial.

SETTING

  Research laboratory.

PATIENTS OR OTHER PARTICIPANTS

  Fifty recreational athletes with self-reported CAI were randomly assigned to a vibration (VIB), nonvibration (NVIB), or control group.

INTERVENTION(S)

  The VIB and NVIB groups performed unilateral balance training on a BOSU 3 times weekly for 6 weeks. The VIB group trained on a vibration platform, and the NVIB group trained on the floor.

MAIN OUTCOME MEASURE(S)

  We assessed balance using the Biodex Balance System and the Star Excursion Balance Test (SEBT). Body composition was measured by dual-energy x-ray absorptiometry.

RESULTS

  After 6 weeks of training, improvements on the Biodex Balance System occurred only on the Overall Stability Index ( P = .01) and Anterior-Posterior Stability Index ( P = .03) in the VIB group. We observed better performance in the medial ( P = .008) and posterolateral ( P = .04) directions and composite score of the SEBT in the VIB group ( P = .01) and in the medial ( P < .001), posteromedial ( P = .002), and posterolateral ( P = .03) directions and composite score of the SEBT in the NVIB group ( P < .001). No changes in body composition were found for any of the groups.

CONCLUSIONS

  Only the VIB group showed improvements on the Biodex Balance System, whereas the VIB and NVIB groups displayed better performance on the SEBT.

Low-1 level mechanical vibration improves bone microstructure, tissue mechanical properties and porous titanium implant osseointegration by promoting anabolic response in type 1 diabetic rabbits

Type 1 diabetes mellitus (T1DM) is associated with reduced bone mass, increased fracture risk, and impaired bone defect regeneration potential. These skeletal complications are becoming important clinical challenges due to the rapidly increasing T1DM population, which necessitates developing effective treatment for T1DM-associated osteopenia/osteoporosis and bone trauma. This study aims to investigate the effects of whole-body vibration (WBV), an easy and non-invasive biophysical method, on bone microstructure, tissue-level mechanical properties and porous titanium (pTi) osseointegration in alloxan-diabetic rabbits. Six non-diabetic and twelve alloxan-treated diabetic rabbits were equally assigned to the Control, DM, and DM with WBV stimulation (WBV) groups. A cylindrical drill-hole defect was established on the left femoral lateral condyle of all rabbits and filled with a novel non-toxic Ti2448 pTi. Rabbits in the WBV group were exposed to 1h/day WBV (0.3g, 30Hz) for 8weeks. After sacrifice, the left femoral condyles were harvested for histological, histomorphometric and nanoindentation analyses. The femoral sample with 2-cm height above the defect was used for qRT-PCR analysis. The right distal femora were scanned with μCT. We found that all alloxan-treated rabbits exhibited hyperglycemia throughout the experimental period. WBV inhibited the deterioration of cancellous and cortical bone architecture and tissue-level mechanical properties via μCT, histological and nanoindentation examinations. T1DM-induced reduction of bone formation was inhibited by WBV, as evidenced by elevated serum OCN and increased mineral apposition rate (MAR), whereas no alteration was observed in bone resorption marker TRACP5b. WBV also stimulated more adequate ingrowths of mineralized bone tissue into pTi pore spaces, and improved peri-implant bone tissue-level mechanical properties and MAR in T1DM bone defects. WBV mitigated the reductions in femoral BMP2, OCN, Wnt3a, Lrp6, and β-catenin and inhibited Sost mRNA expression but did not alter RANKL or RANK gene expression in T1DM rabbits. Our findings demonstrated that WBV improved bone architecture, tissue-level mechanical properties, and pTi osseointegration by promoting canonical Wnt signaling-mediated skeletal anabolic response. This study not only advances our understanding of T1DM skeletal sensitivity in response to external mechanical cues but also offers new treatment alternatives for T1DM-associated osteopenia/osteoporosis and osseous defects in an economic and highly efficient manner.

Effect of whole-body vibration exercise in preventing falls and fractures: a systematic review and meta-analysis

OBJECTIVE

To investigate the effect of whole-body vibration exercise (WBV) on fracture risk in adults ≥50 years of age.

DESIGN

A systematic review and meta-analysis calculating relative risk ratios, fall rate ratio and absolute weighted mean difference using random effects models. Heterogeneity was estimated using I2 statistics, and the Cochrane Collaboration's risk of bias tool and the GRADE approach were used to evaluate quality of evidence and summarise conclusions.

DATA SOURCES

The databases PubMed, Embase and the Cochrane Central Register from inception to April 2016 and reference lists of retrieved publications.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Randomised controlled trials examining the effect of WBV on fracture risk in adults ≥50 years of age. The primary outcomes were fractures, fall rates and the proportion of participants who fell. Secondary outcomes were bone mineral density (BMD), bone microarchitecture, bone turnover markers and calcaneal broadband attenuation (BUA).

RESULTS

15 papers (14 trials) met the inclusion criteria. Only one study had fracture data reporting a non-significant fracture reduction (risk ratio (RR)=0.47, 95% CI 0.14 to 1.57, P=0.22) (moderate quality of evidence). Four studies (n=746) showed that WBV reduced the rate of falls with a rate ratio of 0.67 (95% CI 0.50 to 0.89, P=0.0006; I2=19%) (moderate quality of evidence). Furthermore, data from three studies (n=805) found a trend towards falls reduction (RR=0.76, 95% CI 0.48 to 1.20, P=0.24; I2=24%) (low quality of evidence). Finally, moderate to low quality of evidence showed no overall effect on BMD and only sparse data were available regarding microarchitecture parameters, bone turnover markers and BUA.

CONCLUSIONS

WBV reduces fall rate but seems to have no overall effect on BMD or microarchitecture. The impact of WBV on fractures requires further larger adequately powered studies. This meta-analysis suggests that WBV may prevent fractures by reducing falls.

PROSPERO REGISTRATION NUMBER

CRD42016036320; Pre-results.

Do 6 months of whole-body vibration training improve lean mass and bone mass acquisition of adolescent swimmers?

Swimming has little effect on bone mass. Therefore, adolescent swimmers should complement their water training with a short and intense weight-bearing training, aiming to increase their bone acquisition. Forty swimmers performed a six-month whole-body vibration (WBV) training. WBV had no effect on adolescent swimmers' bone mass or lean mass.

PURPOSE

The aims of the present study were to evaluate the effects of a whole-body vibration (WBV) intervention on bone mineral density (BMD), bone mineral content (BMC) and lean mass (LM) in adolescent swimmers.

METHODS

Forty male and female adolescent swimmers (VIB; mean age 14.2 ± 1.9 years) completed the WBV protocol that consisted of 15 min of training 3 days per week during a 6-month period (ranging from 3.6 to 11.6 g), while 23 swimmers (SWI; mean age 15.0 ± 2.2 years) continued with their regular swimming training alone. VIB were divided into tertiles according to training compliance in order to evaluate if any dose-effect relation existed. BMD, BMC and LM were measured longitudinally by dual energy X-ray at the whole body, lumbar-spine and hip.

RESULTS

No group by time interactions and no differences in change percentage were found for BMD, BMC or LM in any of the measured variables. The mean change percentage of the subtotal body (whole body minus the head) for VIB and SWI, respectively, was 2.3 vs. 2.4% for BMD, 5.7 vs 5.7% for BMC and 7.3 vs. 8.0% for lean mass. Moreover, no indication for dose-response was observed.

CONCLUSIONS

The proposed WBV protocol had no effect on BMD, BMC and LM in adolescent swimmers. Other types of training should be used in this population to improve both bone and lean mass.

Limb Segment Load Inhibits the Recovery of Soleus H-Reflex After Segmental Vibration in Humans

We investigated the effects of vertical vibration and compressive load on soleus H-reflex amplitude and postactivation depression. We hypothesized that, in the presence of a compressive load, limb vibration induces a longer suppression of soleus H-reflex. Eleven healthy adults received vibratory stimulation at a fixed frequency (30 Hz) over two loading conditions (0% and 50% of individual's body weight). H-reflex amplitude was depressed ∼88% in both conditions during vibration. Cyclic application of compression after cessation of the vibration caused a persistent reduction in H-reflex excitability and postactivation depression for > 2.5 min. A combination of limb segment vibration and compression may offer a nonpharmacologic method to modulate spinal reflex excitability in people after CNS injury.

Effects of whole-body vibration on balance and mobility in institutionalized older adults: a randomized controlled trial

OBJECTIVE

To investigate whether a comprehensive exercise program was effective in improving physical function among institutionalized older adults and whether adding whole-body vibration to the program conferred additional therapeutic benefits.

DESIGN

A single-blinded randomized controlled trial was conducted.

SETTING

This study was carried out in residential care units.

PARTICIPANTS

In total, 73 older adults (40 women, mean age: 82.3 ± 7.3 years) were enrolled into this study.

INTERVENTIONS

Participants were randomly allocated to one of the three groups: strength and balance program combined with whole-body vibration, strength and balance program without whole-body vibration, and social and recreational activities consisting of upper limb exercises only. All participants completed three training sessions per week for eight weeks.

OUTCOME MEASURES

Assessment of mobility, balance, lower limb strength, walking endurance, and self-perceived balance confidence were conducted at baseline and immediately after the eight-week intervention. Incidences of falls requiring medical attention were recorded for one year after the end of the training period.

RESULTS

A significant time × group interaction was found for lower limb strength (five-times-sit-to-stand test; P = 0.048), with the exercise-only group showing improvement (pretest: 35.8 ± 16.1 seconds; posttest: 29.0 ± 9.8 seconds), compared with a decline in strength among controls (pretest: 27.1 ± 10.4 seconds; posttest: 28.7 ± 12.3 seconds; P = 0.030). The exercise with whole-body vibration group had a significantly better outcome in balance confidence (pretest: 39.2 ± 29.0; posttest: 48.4 ± 30.6) than the exercise-only group (pretest: 35.9 ± 24.8; posttest: 38.2 ± 26.5; P = 0.033).

CONCLUSION

The exercise program was effective in improving lower limb strength among institutionalized older adults but adding whole-body vibration did not enhance its effect. Whole-body vibration may improve balance confidence without enhancing actual balance performance.

Various performance-enhancing effects from the same intensity of whole-body vibration training

PURPOSE

The purpose of this study was to compare the effects of an 8-week whole-body vibration training program in various frequency and amplitude settings under the same acceleration on the strength and power of the knee extensors.

METHODS

Sixty-four young participants were randomly assigned to 1 of 4 groups with the same acceleration (4 g): high frequency and low amplitude (n = 16, 32 Hz, 1 mm) group, medium frequency and medium amplitude (n = 16, 18 Hz, 3 mm) group, low frequency and high amplitude (n = 16, 3 Hz, 114 mm) group, and control (n = 16, no vibration) group. All participants underwent 8 weeks of training with body mass dynamic squats, 3 sessions a week.

RESULTS

The results showed that the high frequency and low amplitude group increased significantly in isometric contraction strength and 120°/s isokinetic concentric contraction strength; the medium frequency and medium amplitude group increased significantly in 60°/s and 120°/s isokinetic strength of both concentric and eccentric contraction; and the low frequency and high amplitude group increased significantly in 60°/s and 120°/s isokinetic eccentric contraction strength.

CONCLUSION

All frequency and amplitude settings in the 8-week whole-body vibration training increased muscle strength, but different settings resulted in various neuromuscular adaptations despite the same intensity.

Effects of whole-body vibration on neuromuscular performance in individuals with spinal cord injury: a systematic review

OBJECTIVE

To examine the effects of whole-body vibration on neuromuscular performance in people with spinal cord injury and evaluate the safe and effective vibration protocols.

METHODS

PubMed, EMBASE, CINAHL and PEDro were mainly searched for English literatures. Other data sources were ClinicalTrials.gov , Current Controlled Trials and reference lists of all relevant articles. The PEDro scale was used to evaluate the methodological quality, and the Oxford Centre for Evidence-based Medicine level of evidence was used to assess the level of evidence. Basic information and whole-body vibration protocols were extracted by two independent researchers. Any disagreements were resolved by the third researcher.

RESULTS

Of the eight included studies involving 94 individuals with spinal cord injury and 24 able-bodied participants, six of them reported beneficial effects of whole-body vibration on muscle activation and the other two on muscle spasticity. Based on the reviewed studies, an intermittent mode of whole-body vibration (frequency: 10-50 Hz; amplitude: 0.6-4 mm) is less likely to cause adverse events when applying to spinal cord injury subjects standing on platform (knees flexed at 10°-40°).

CONCLUSIONS

The strength of evidence is insufficient in supporting the benefits of whole-body vibration on neuromuscular performance in individuals with spinal cord injury. The intermittent vibration (frequency: 10-50 Hz; amplitude: 0.6-4 mm; knee flexion: 10°-40°) may be the possible effective range and have good compliance.

The effects of long-term whole-body vibration and aerobic exercise on body composition and bone mineral density in obese middle-aged women

PURPOSE

The purpose of this study was to determine the effectiveness of whole-body passive vibration exercise and its differences from aerobic exercise on body composition, bone mineral density (BMD) and bone mineral content (BMC).

METHODS

Obese middle-aged women (n=33 out of 45) with 34±3% body fat completed the training protocol. They were randomly assigned into diet (n=9; control group), diet plus whole-body vibration exercise (n=13; vibration group), and diet plus aerobic exercise (n=11; aerobic group) groups and we compared their body composition, BMD, and BMC before and after 9 months of training. There were no significant differences in nutrient intake among groups during the training period.

RESULTS

Relative body fat (%) decreased significantly (p < .05) in all three groups and the exercise groups showed a greater reduction in fat mass than the diet only group. BMD in the whole body, lumbar spine, hip and forearm were not significantly different among the three groups. Total body BMC increased significantly in the vibration group throughout the first 6 months of training.

CONCLUSION

Results suggest that long- term vibration training when used in conjunction with a diet program is as effective as aerobic exercise with a diet program in improving body composition of obese middle-aged women without compromising BMC or BMD. Thus, it can be considered a novel and effective method for reducing body fat.